LIFESPAN NEUROPSYCHOLOGY AND COUNSELING CENTER, LLC (NPI# 1689181638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689181638 |
| Entity Type | Organization |
| Organization Name | LIFESPAN NEUROPSYCHOLOGY AND COUNSELING CENTER, LLC |
| Other Organization Name | LIFESPAN NEUROPSYCHOLOGY AND CLINICAL NEUROSCIENCE, LLC |
| Practice Address |
2060 Oak Tree Rd 3rd Floor Edison NJ 08820 |
| Practice Telephone | 9084721255 |
| Practice Fax Number | 8482007713 |
| Mailing Telephone | 9084721255 |
| Mailing Fax Number | 8482007713 |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2019-11-27 |
| Authorized Official Name | DR. GEORGIANNA DART (OWNER) |
| Authorized Official Telephone | 9084721255 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 4987 | NJ | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Lifespan Neuropsychology and Clinical Neuroscience, LLC | Former Legal Business Name - Organization |
| Street Address |
2060 OAK TREE RD 3RD FLOOR |
| City | EDISON |
| State | NJ |
| Zip Code | 08820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801007430 | Brad M Strober | Dentist | 2060 Oak Tree Rd, Edison, NJ 08820-2058 | 2007-05-25 |
| 1922427707 | Cynthia Butcofski | Dentist | 2060 Oak Tree Rd, Edison, NJ 08820-2058 | 2014-04-09 |
| 1023442225 | Lynnanne Naples | Occupational Therapist | 2060 Oak Tree Rd, Edison, NJ 08820-2058 | 2013-08-25 |
| 1982970851 | Hundal Neuropsychology Group, LLC | Clinical Neuropsychologist | 2060 Oak Tree Rd, 3rd Floor, Edison, NJ 08820-2058 | 2012-03-26 |
| 1043476963 | Indravadan T Patel Md Pa | Internal Medicine | 2060 Oak Tree Rd, Edison, NJ 08820-2058 | 2008-07-30 |
| 1659561389 | David Michael Hart | Dentist | 2060 Oak Tree Rd, Gentle Dental Care, LLC, Edison, NJ 08820-2058 | 2007-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457964702 | Time Line Diagnostic LLC | Spec/Tech, Cardiovascular | 25 Cinder Road Apt 3j, Edison, NJ 08820 | 2020-08-26 |
| 1376185504 | Jason Chester | Physical Therapist | 72 Nj-27, Edison, NJ 08820 | 2019-10-09 |
| 1497237838 | Pooja Kansagra | Behavior Technician | 3826 Park Ave Suite 102, Edison, NJ 08820 | 2018-09-01 |
| 1568941086 | Thomas Dipaolo LLC | Physical Therapist | 3840 Park Ave # D108, Edison, NJ 08820 | 2018-08-07 |
| 1467939561 | Aisha Musa Abdulkadir | Student in an Organized Health Care Education/Training Program | Jfk Family Practice, 65 James Street, Edison, NJ 08820 | 2018-07-23 |
| 1801380522 | Edison Spine and Pain Management, P.C. | Physical Medicine & Rehabilitation | 1692 Oak Tree Road, Edison, NJ 08820 | 2018-06-16 |
| 1386136521 | Chirag A Gandhi | Physical Therapist | 3830 Park Ave Ste 202, Edison, NJ 08820 | 2018-06-04 |
| 1770097446 | Arthur Royzner | Dentist | 1 Lincoln Hwy Ste 6, Edison, NJ 08820 | 2017-11-16 |
| 1356850671 | Nj Allergy & Asthma Care LLC | Clinic/Center | 26 Parker Rd, Edison, NJ 08820 | 2017-09-29 |
| 1790226223 | Julianna Marie Zilli | Specialist/Technologist | 24 Woodrow Wilson Dr, Edison, NJ 08820 | 2017-03-16 |
| Find all providers in zip 08820 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811325152 | Amy L. Hradil | Clinical Neuropsychologist | 2048 Oak Tree Road Center for Head Injuries, Cognitive Rehabilitation Progr, Edison, NJ 08820 | 2013-10-24 |
| 1982786588 | Charlotte Thornhill Trott | Clinical Neuropsychologist | 2048 Oak Tree Rd, Center for Head Injuries; Jfk-johnson Rehabilitation, Edison, NJ 08820-2012 | 2006-10-20 |
| 1134620313 | Erin Fults | Clinical Neuropsychologist | 2048 Oak Tree Rd, Edison, NJ 08820-2012 | 2018-02-23 |
| 1164959490 | Sara Flood | Clinical Neuropsychologist | 2048 Oak Tree Rd, Edison, NJ 08820-2012 | 2017-05-17 |
| 1386170124 | Tessa Mellow | Clinical Neuropsychologist | 2048 Oak Tree Rd, Edison, NJ 08820-2012 | 2017-05-11 |
| 1487024121 | Maria Wedin | Clinical Neuropsychologist | 2048 Oak Tree Rd, Edison, NJ 08820-2012 | 2015-10-06 |
| 1063765808 | Yelena Goldin | Clinical Neuropsychologist | 2048 Oak Tree Rd, Edison, NJ 08820-2012 | 2012-10-17 |
| 1427301258 | Sarah West | Clinical Neuropsychologist | 2048 Oak Tree Rd, Edison, NJ 08820-2012 | 2012-10-17 |
| 1750644324 | Georgianna Dart | Clinical Neuropsychologist | 65 James St, Center for Head Injuries, Edison, NJ 08820-3947 | 2012-06-19 |
| 1982970851 | Hundal Neuropsychology Group, LLC | Clinical Neuropsychologist | 2060 Oak Tree Rd, 3rd Floor, Edison, NJ 08820-2058 | 2012-03-26 |
| Find all providers in EDISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.